Home-Based Automated Therapy of Arm Function After Stroke Via Tele-Rehabilitation
| Status: | Completed |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 19 - Any |
| Updated: | 9/30/2018 |
| Start Date: | June 2010 |
| End Date: | August 2018 |
Constraint-Induced Movement therapy, also known as CI therapy, is an approach to physical
rehabilitation derived from basic behavioral and neuroscience research. It has been shown to
be efficacious for rehabilitating use of the more-affected arm in individuals more than one
year after stroke with mild to moderate motor impairment. The first component of the therapy
is intensive training in use of the more-affected arm on functional tasks for 3 hours daily
for 10 consecutive weekdays. The second is wearing a protective safety mitt on the
less-affected hand for all waking hours of the approximately 2-week treatment period that it
is safe to do so. The purpose of the mitt is to discourage use of the less-affected arm. The
third is a group of behavioral techniques designed to transfer gains from the treatment
setting to the real world, which takes a therapist, on average, 30 minutes to implement on
each treatment day.
The purpose of this project is to develop and test a method for automating the delivery of
this efficacious treatment in a way that the therapy can be provided in stroke patients'
homes. After developing an automated CI therapy workstation that has tele-health
capabilities, the investigators will conduct a randomized controlled trial to evaluate
whether CI therapy delivered in the home using this workstation with remote supervision by a
therapist via an Internet-based audiovisual link provides outcomes that are just as good as
CI therapy delivered by a "live" therapist.
rehabilitation derived from basic behavioral and neuroscience research. It has been shown to
be efficacious for rehabilitating use of the more-affected arm in individuals more than one
year after stroke with mild to moderate motor impairment. The first component of the therapy
is intensive training in use of the more-affected arm on functional tasks for 3 hours daily
for 10 consecutive weekdays. The second is wearing a protective safety mitt on the
less-affected hand for all waking hours of the approximately 2-week treatment period that it
is safe to do so. The purpose of the mitt is to discourage use of the less-affected arm. The
third is a group of behavioral techniques designed to transfer gains from the treatment
setting to the real world, which takes a therapist, on average, 30 minutes to implement on
each treatment day.
The purpose of this project is to develop and test a method for automating the delivery of
this efficacious treatment in a way that the therapy can be provided in stroke patients'
homes. After developing an automated CI therapy workstation that has tele-health
capabilities, the investigators will conduct a randomized controlled trial to evaluate
whether CI therapy delivered in the home using this workstation with remote supervision by a
therapist via an Internet-based audiovisual link provides outcomes that are just as good as
CI therapy delivered by a "live" therapist.
Inclusion Criteria:
- more than 1 year after stroke
- some ability to voluntarily open fingers on more affected side of body
- some ability to voluntarily raise wrist on more affected side of body
- ability to stand independently for two minutes
- ability to transfer from sit to stand independently
Exclusion Criteria:
- serious, concurrent medical conditions including frailty
- excessive spasticity (high muscle tone) in more affected arm
- impairment in thinking that makes compliance with study activities difficult
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University of Alabama at Birmingham The University of Alabama at Birmingham (UAB) traces its roots...
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